Stereotactic Radiation May Help in Early Lung Cancer

by Ed Susman Contributing Writer, MedPage Today

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This study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

Compared with historical reports, the use of stereotactic body radiation therapy in inoperable early lung cancer appears to result in better 3-year and 5-year survival rates.

Note that stereotactic body radiation therapy was well-tolerated with only mild toxicity.

BOSTON -- Compared with historical reports, the use of stereotactic body radiation therapy in inoperable early lung cancer appears to result in longer 3-year and 5-year survival, Japanese researchers reported here.

About 60% of 104 patients diagnosed with Stage IA non-small cell lung cancer achieved a 3-year overall survival and 40.8% were alive at 5 years, said Yasushi Nagata, MD, professor and chairman of radiation oncology at the University of Hiroshima, at a press briefing during the annual meeting of the American Society for Radiation Oncology.

"Our study found that stereotactic body radiation therapy for inoperable lung cancer patients was highly effective and showed mild toxicity," Nagata said. "This treatment should be the new standard, replacing conventional radiotherapy for this population of patients."

Even though the patients in the study had very early stage cancer -- T1N0M0, Nagata told MedPage Today, "These patients were inoperable mainly because of their age and other comorbid conditions, as they were smokers, and their pulmonary function was compromised. We felt that stereotactic radiotherapy was the better choice for them."

He said that stereotactic body radiation therapy is less invasive, is believed to be effective against early stage lung cancer and was found to be feasible in patients with operable cancer. "This presentation is the first report for inoperable population," he said in his oral presentation.

Nagata noted that while the population he selected was generally older that other groups -- median age of 78 (range of 59-90) -- the outcomes compared with conventional radiation therapy were better. Patients were recruited between 2004 and 2008 from 15 institutions. Patients underwent four radiotherapy treatments over the course of 4 to 8 days.

Other studies of conventional radiation for inoperable non-small cell lung cancer have registered three year survival in the 31% to 39% range; and 5-year survival in these studies has ranged from 13-22.2%, Nagata said.

At the 3-year follow-up, progression-free survival was 49.8%, local progression-free survival was 52.8% and event-free survival was 46.8%.

The study included 77 men and 27 women who each received a total radiation dose of 48 Gray. The median tumor size was 21 mm, and all patients completed the protocol treatment.

Four patients were eliminated from the study results after completion -- three patients were diagnosed with another cancer within 5 years after registration, and one patient was unexpectedly treated with stereotactic body radiation therapy in combination with chemotherapy.

"Surgery remains the standard of care for early-stage lung cancer," Catherine Park, MD, associate professor of radiation oncology at the University of California, San Francisco, told MedPage Today. "There are ongoing clinical trials now that compare stereotactic body radiation therapy with other treatment modalities."

Nagata and co-authors had no disclosures. Commenter Park disclosed commercial interests with Oncosynergy.

Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

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